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SHIP'S STORES DECLARATION

(IMO FAL Form 3)

Page Number
Arrival Departure

1.1 Name of ship 1.2 IMO number

1.3 Call sign 1.4 Voyage number

2. Port of arrival/departure 3. Date of arrival/departure

4. Flag State of ship 5. Last port of call/Next port of call

6. Number of persons on board 7. Period of stay

8. Name of article 9. Quantity 10. Location on board 11. Official use

12. Date and signature by master, authorized agent or officer

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